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Top UN challenges

Posted on 23 September 2016

A new study assessing the status of the UN’s Sustainable Development Goals (SDGs) has revealed that overweight children, adult drinking and death caused by violence continue to be significant hurdles in many nations’ development.

Last year, the UN General Assembly established 17 universal Sustainable Development Goals (SDGs) including 169 targets, and 230 indicators leading up to the year 2030 to improve quality of life.

Now, a year on, the international Global Burden of Disease Study (GBD) collaboration, which includes a University of York health scientist, has produced a report offering insights into progress and challenges in achieving these goals.

Providing an analysis of 33 health-related SDG indicators, the study’s top findings show:

• Significant improvement in child and maternal survival over the past 25 years - expanded health coverage, greater access to family planning, and fewer deaths of newborns and children under the age of 5 are among several areas of health improvement
• However, childhood obesity, alcohol consumption, and death caused by violence continue to be significant problems in hindering development
• More skilled doctors, nurses, and midwives are assisting with child deliveries
• Many countries have increased access to essential health services, especially antiretroviral therapies to treat HIV and the availability of malaria nets
• Fewer people are dying from unsafe drinking water and poor sanitation, as well as air pollution
• Countries with higher socio-demographic standing saw faster declines in deaths from chronic disease, road injuries, and violence
• Countries in the lower socio-demographic groups saw faster declines in childhood wasting and stunting

Published in The Lancet, the GBD analysed each country’s progress toward achieving health-related SDG targets by creating an overall SDG Index score. Countries were then ranked by their scores to show which nations are closest to achieving the targets.

A nation’s SDG index score is based on a scale of zero to 100. As a result, Iceland tops the list with a score of 85. The lowest-scoring nation was the Central African Republic, at 20. The United States has a score of 75, just behind Slovenia, Greece, and Japan, all at 76.

To see how nations compare to others, countries were divided into five categories, based on a combination of education, fertility, and income per capita. This new categorisation goes beyond the historical “developed” vs. “developing” or economic divisions based solely on income.

Countries showing significant improvements include Brazil in making good progress in reducing child deaths, eliminating nearly 50 percent of its under-age-5 child deaths in the past 15 years. In 2000, 31 children died for every 1,000 live births compared to 17 in 2015. Kenya’s SDG Index score also increased between 2000 and 2015, from 33 to 40. In 2015, 70 percent of Kenyans who needed an essential health intervention received it, in contrast to just 32 percent in 2000.

The researchers note that these gains will need to be sustained, and in many cases accelerated, to achieve the ambitious SDG targets. The findings also highlight the importance of income, education, and birth rates as drivers of health improvement, and that investment in those areas alone will not be sufficient.

Dr Amanda Mason-Jones, Senior Lecturer in Global Health in York’s Department of Health Sciences and collaborator on the study, said: “There are still glaring global inequalities but the development of the index is a good start to begin to measure progress towards the SDGs, especially as it includes education and fertility as key indicators of health and wellbeing, which are the focus my own research.”

Dr Stephen S. Lim, Professor of Global Health at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, and lead author of study, said: “We have concrete examples of countries making important progress on a range of health-related SDG indicators. We now need to look to those countries that have seen strong progress to find out what they are doing right and how it can be applied more broadly.”

Christopher J.L. Murray, Director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, who co-ordinated the study, said:  “We know that international targets can motivate countries and motivate donors. The international Global Burden of Disease collaboration is committed to providing an independent assessment of progress toward the Sustainable Development Goals.”